Vermont Case Management Organizations: Benchmark vs Columbus for DD Services

Before the 2025 reforms, your local Designated Agency in Vermont handled intake, case management, and direct services. PCG took over statewide intake on August 11, 2025, and case management moved to independent organizations on October 1, 2025. That created an obvious conflict of interest: the same organization deciding what services someone needed was also the organization getting paid to deliver those services. Federal CMS conflict-free requirements forced Vermont to separate these functions, and the result is a new system that most families are still trying to understand.

What Changed and Why

Under the old model, a Designated Agency like Howard Center, Washington County Mental Health, or Lamoille County Mental Health would evaluate your young adult's needs, develop the service plan, manage the budget, and then provide the actual care. The agency was simultaneously the gatekeeper and the vendor.

The federal Home and Community-Based Services (HCBS) regulations required states to eliminate this conflict. Vermont responded by splitting case management into independent entities that are separate from the agencies delivering direct care. These independent entities are called Care Management Organizations (CMOs).

As of October 2025, two CMOs operate in Vermont:

• Benchmark Human Services — a national organization with operations across multiple states
• The Columbus Organization — another national entity specializing in developmental disability case management

What the CMO Does

Your CMO handles the administrative side of services. Specifically:

• Conducts standardized needs assessments (including the Supports Intensity Scale, SIS-A)
• Develops the Individualized Service Plan (ISP) based on the assessment
• Manages the service budget — how much funding is allocated and how it is distributed across supports
• Monitors whether services are being delivered as planned
• Coordinates with direct care providers (which are still your local Designated Agencies or independent providers)

The CMO does not provide hands-on care. They do not send staff to your home, operate day programs, or manage supported employment placements. That is still the role of the Designated Agency or independent providers you choose.

How to Choose Between Benchmark and Columbus

When a young adult receives a funded service authorization, the family selects a CMO. In practice, the choice may be influenced by which organization has availability in your region and which case managers are currently taking new clients.

Questions to ask during the selection process:

• What is the current case manager caseload? Lower caseloads generally mean more responsive service. Ask how many individuals each case manager currently supports.
• How are ISP meetings scheduled? Some CMOs default to virtual meetings; others offer in-person options. For families navigating a complex initial service plan, in-person meetings may be more effective.
• What is the process for requesting a change in services or budget? Understand how quickly the CMO can respond to a change in circumstances — a new medical need, a provider leaving, or a safety concern.
• Can we request a specific case manager? If another family has had a positive experience with a particular case manager, ask whether that person is available.

The Role of Your Designated Agency Under the New System

Your local DA still delivers the actual services — shared living, supported employment, community supports, day programs, respite. What they no longer do is decide what services you receive or manage the budget. That separation is the entire point of the reform.

For families, this means you now have two points of contact: the CMO (for planning and budgets) and the DA or independent provider (for day-to-day services). If a service is not being delivered as planned, the complaint goes to the CMO. If a direct care worker is not a good fit, that conversation happens with the provider agency.

What to Watch For

The conflict-free system is new, and the transition has not been seamless. Some families report confusion about which entity to contact for different issues. Others have experienced delays as CMOs build their Vermont operations and hire local staff.

Document every interaction with your CMO — meeting notes, email confirmations, phone call summaries. If you disagree with an ISP or budget decision, you have the right to request a review. Disability Rights Vermont can help families who feel the ISP does not adequately address documented needs.

For a complete CMO comparison framework, ISP meeting preparation checklist, and the rights families retain in the conflict-free system, see our Vermont SSI at 18 & Adult Disability Benefits Guide.

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